Published by Atlantic Institute for Market Studies

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Is it time to destroy the dogma against private healthcare?

The 18th-century French political theorist Joseph de Maistre is famous for having written that people get “the government they deserve.” In Atlantic Canada, you could say that we get the healthcare we deserve.

I have no family doctor in Halifax, so like many residents I go to a walk-in clinic to see a doctor. All told, it is a pretty good service. Anyone can go, and provided that they are legal residents or citizens the cost of medical advice is covered by the state’s medicare system. The downside, of course, is wait times. On a recent visit I waited about three hours to get in — not intolerable, but certainly an inconvenience.

Given the popularity of our single-payer, socialized health system, I was surprised to see how many of the co-patrons were visibly frustrated by the wait. About every 15 minutes, someone would walk up to ask the poor receptionist how much longer it would take to see the doctor. But how many of these people would support the introduction of private options to our health system, such that one could pay out-of-pocket, or benefit from insurance coverage, for a similar service that forwent the rationing of the public-only model? For those who could not afford to pay, their wait times in public clinics would surely be reduced, if those who were willing and able to do so decamped to private care.

In my native Prince Edward Island, dissatisfaction with the congested health system is a perennial topic of public discourse. And yet the possibility of deflating the problem through more choice and fee-based services gains no traction. People seem to think that keeping out private health care is some kind of patriotic duty, no matter how bad the public service.

People clearly want to pay for the rickshaw and receive the Mercedes.

It’s all totally irrational: by maintaining the Soviet shoe factory model for health service delivery, we rob ourselves of the chance for more efficient, market-driven options. And things are getting worse: health spending as a share of provincial budgets has risen in recent years, taking valuable funds away from other important programs and contributing to a high tax burden.

If we are to be serious about improving health services, Item #1 has to be destroying the dogma against private care options. Only once people stop seeing the possibility as a taboo can their grievances against the system be legitimate.